Individual
CHAIM SHTOCK
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Contact information
Practice address
621 GRAVESEND NECK RD, BROOKLYN, NY 11223-5126
(718) 382-6669
Mailing address
1880 E 4TH ST, APT B14, BROOKLYN, NY 11223-2834
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
221006
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02413647
—
NY
Enumeration date
02/28/2006
Last updated
07/08/2007
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